Homeless and Helpless

Hundreds of thousands of Americans face the holidays without shelter and without hope.

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This year marks the 50th anniversary of the assassination of President John Kennedy and the legislation that he championed, commonly called the Community Mental Health Centers Act.

In his remarks to Congress, the president said (and no doubt believed) that "when carried out, reliance on the cold mercy of custodial isolation will be supplanted by the open warmth of community concern and capability." He must be rolling over in his grave.

On a single night in January 2012, a total of 111,993 men and women with severe mental illness were reported to be homeless in America. Of those, 46,550 were sleeping unsheltered — on the streets, in parks and abandoned buildings, under overpasses and bridges, in tents, sheds, barns, and other places "not meant for human habitation."

E. Fuller Torrey is the executive director of the Stanley Medical Research Institute and a prolific, noted author of books about homeless mentally ill people. He is also a board member of the Treatment Advocacy Center, which released a report in May 2010 that validates his militant advocacy for assisted outpatient treatment.

That report, "More Mentally Ill Persons Are in Jails and Prisons than Hospitals: A Survey of the States," reported that "there are now more than three times more seriously mentally ill persons in jails and prisons than in hospitals."

The report went on to state that "America's jails and prisons have become our new mental hospitals" and that "40 percent of individuals with serious mental illnesses have been in jail or prison at some time in their lives." At its heart is the reality, expressed by Torrey in October 2013, that "It is almost impossible to get someone committed."

Nobody gets the bottom line of the issue better than the National Association of Mental Health Directors, who reported in 2012 that "We are spending money in all the wrong places — prisons, emergency departments, and homeless shelters — when the illnesses become more serious."

Nobody gets the need for changes in the system better than families who are heartsick at what is happening to their loved ones — or worse, what may happen to them or others if he or she becomes one of the small minority of those who are too dangerous to themselves or others to remain in the community without effective mental-health treatment.

Lest we forget, also among the total of 633,782 homeless people located in the January 2012 "point-in-time" count were an additional 274,611 individuals unaccompanied by children and 84,030 families with children. Shamefully, 19,428 of those families were also sleeping unsheltered (many of them in the dead of winter in some of our coldest and most rural states).

The total number reported to have been homeless during 2012 was 1,502,196. For most of these families, safe, decent, affordable housing could end their house-lessness, but rebuilding their lives to help ensure that their children will not become homeless adults will take much more — including health care and mental-health care to deal with the trauma of homelessness.

Earlier this year, the federal government was shut down for 16 days, due to the relentless efforts by a vocal, divisive minority to repeal the Patient Protection and Affordable Care Act (aka "Obamacare"). These critics seemed unmindful of their own claim that the recent rash of mass-shooting fatalities, including the soul-sickening slaughter of 20 children at Newtown, were essentially the result of untreated mental illness and the failure of the mental-health system.

When and if some early kinks are corrected, as surely they will be, and Obamacare is fully implemented, it will provide health insurance for 60 million Americans, including those who are homeless and currently lack health insurance.

I remain hopeful that Americans of good will can and will find a way to ensure that none of our most vulnerable men, women, youth, and children, further traumatized by homelessness, are left behind. My basis for that confidence?

Words of President Kennedy, spoken at his inauguration, are inscribed in stone at his gravesite in Arlington National Cemetery: "With a good conscience our only sure reward, with history the final judge of our deeds, let us go forth to lead the land we love, asking His blessing and His help, but knowing that here on earth God's work must truly be our own."

Memphian Pat Morgan is a recognized authority on the problem of homelessness in America. This essay is adapted from the Afterword of her new book, The Concrete Killing Fields.